1. Adverse Childhood Experiences: The Hidden Crisis in Our Community

2. Understanding Stress Positive Stress Tolerable Stress Toxic Stress

3. ACEs are:  Surprisingly common  Occur in clusters  The basis for many common public health problems  Strong predictors of later social functioning, well-being, health risks, disease, and death

4. “The impact of ACEs can now only be ignored as a matter of conscious choice. With this information comes the responsibility to use it.” Anda and Brown, CDC

5. ACE Scores  1/3 of adults have an ACE score of 0  The majority of adults with an ACE score of 0 have few, if any, risk factors for diseases that are common causes of death in the US.

6. Top 10 risk factors for death in the USA Smoking Severe Obesity Physical Inactivity Depression Suicide Attempt Alcoholism Illicit Drug Use Injected Drug Use 50+ Sexual Partners History Of STD

7. Alcohol, tobacco & other drug addiction Auto-immune disease Chronic obstructive pulmonary disease & ischemic heart disease Depression, anxiety & other mental illness Diabetes Multiple divorces Fetal death High risk sexual activity, STDs & unintended pregnancy Intimate partner violence—perpetration & victimization Liver disease Lung cancer Obesity Self-regulation & anger management problems Skeletal fractures Suicide attempts Work problems—including absenteeism, productivity & on-the-job injury Life-long Physical, Mental & Behavioral Health Outcomes Linked to ACEs

8. Family Centered Practice, June 8, 2007

10. ACE Score vs. Smoking as an Adult

11. ACE Score vs. Adult Alcoholism

12. ACE Score vs. Chronic Depression

13. How Do We Meet the Challenge?  Gather more data  Raise awareness of ACEs, especially with pediatricians and other healthcare professionals  Support research to identify evidence-based interventions for toxic stress  Provide trauma-informed trainings  Improve access to health care services  Embed Protective Factors in practices of organizations and throughout the community

14. The truth about childhood is stored up in our bodies and lives in our souls. Our intellect can be tricked, our feelings can be numbed and manipulated, our perception shamed and confused, our bodies tricked with medication, but our soul never forgets. And because we are one, one whole soul, in one body, someday our body will present its bill. ~ Alice Miller

15. Information & Resources  ACE Study findings and information - www.acestudy.org or www.cdc.govwww.acestudy.orgwww.cdc.gov  National Scientific Council on the Developing Child at Harvard University - www.developingchild.netwww.developingchild.net  Academy of Pediatrics - www.brightfutures.aap.orgwww.brightfutures.aap.org

16. More Information & Resources  National Center for Trauma-Informed Care – www.mentalhealth.samhsa.gov/nctic www.mentalhealth.samhsa.gov/nctic  National Child Traumatic Stress Network – www.nctsnet.org www.nctsnet.org  Center for the Study of Social Policy - Information on Strengthening Families and Protective Factors – www.cssp.orgwww.cssp.org  Center for Injury Prevention and Control – www.cdc.gov/violenceprevention www.cdc.gov/violenceprevention